HomeMy WebLinkAbout06050092 Application
City of Carmel/Clay Township ~rmit #: tJlJ06 t1iJq;)-
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER of C4.m
RECORD:
PHONE
FAX
845 -oS'1"'!- 3/7-fi1b-O 75'
STREET ADDRESS'!
I )....J. ~'PA
cm
C4
STATE
ZIP
"'1 tos.:?
-'T43.-ot'of
BUILDER'S EMAIL ADDRESS
PROPERTY
OWNER:
NAME
44m (3 R:rc:r::r.=
Co 1U5
LOCATION
&. PROJECT
INFO:
ADDRESS OF CONSTRUCTION
/9':555
SEWER lJT1LIl:O
PROVIDER: ,( ! '/
NAME OF UTILITY VA N CONTRACTOR; PLAN COMMISSION I BZA / BPW DOCKt I
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPLICABLE):
TYPE OF CONSTRUCTION:
fll/SiNGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units:
o MULTI-FAMILY
# of Units:
o RESIDENTIAL (For
Additions, Remodels, Etc.)
PROVEMENT:
NEW STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDITION(S)
o REMODEL
o ACCESSORY BUILDING
o DETACHED GARAGE'
o ATTACHED GARAGE
o DEMOLITION
PROJECT INFORMATION:
Early Release
Permit: _Y tYN
G:
BEST METHOD OF/CONTACT:
FAX
3/7-89'%''07
{c.;::: ", '-
.....~ (':STATE
.." { . ,'"
-"",:: /' :. "'....
'j
000
,
'>a
O.eA-ULE.
PLUMBING CONTRACTOR:
#t?O~.f€/.? T~,40~""
Plumber's Indiana State License #:
/ PoCO tJ Y 1/
Which plumbing codes will be applied to the col1struction:
o International Residential Code wI Indiana Amendments
o Uniform Plumbing Code w/Indiana Amendments
(Multi-Family Construction Code)
Manufactured FOUNDATION TYPE: (Check all that apply for the new
_Y i/:.N construction area)
Trusses:
r /' 0 CRAWLSPACE
Lot Split: _Y ~N Sump Pump: ~ _N 0 SLAB
Does any part of the property lie within a special Flood designation area: _ Y v-N
o EQST & BEAM
rvElASEMENT
WALKOUT:_Y_N
For Single Family and Two Family dwellings, additions, remodels, an,d/or ac~~rfY structures, this permit is valid only if construction commences
within 180 days of the date of ~~JlltBlE:Q)u~J66i)N@cr~~d~eted (Certificate of Occupancy issued) within 18 months of the
issuance date. Class I structure ~6'B)a'cnrfd~mn~1la~ewifN.f\~.~a:mt:Joo&u~es of the Stat~ of Indiana (See 675 lAC 12) regarding expiration
~1}]~'fra~~T8J:,hf~nd completmg constructIon.
I, the undersigned, agree that any constructEdh,geEllirsEt" Qdid-n, eM:~rgementrff~9S41jiDP. or alteration of a structure, or any change in the use of land or
structures requested by this applic(!):~ C9(n~@M MJ1..J:N,lchIft S,fiIn.prpft.eJeN'Jaws of the State of Indiana, and the "Zoning Ordinance of Carmel
Indiana - 1993" (Z- 289) and ame!"J~ '1'lI'>lti~&Ji[r,oeJ:3l.v:m\'vl'\f$ F\1IP'al Assembly of the State of Indiana, and all Acts amendatory
thereto. r certify that onl~kRe , trM11Mr-dra{ns are connected to the sanitary sewer. I further certify that the construction will not be
use r accu ed a tiB CcupaIlc;yha~~ANA by the Department of Community Services, Carmel, Indiana.
L/l5/l, CJ/LI S~~i-()~
rint Date
OFFICE USE ONLY: ***************
ReviewedjAppr ed: Dept. of Community Services
S:~e.rmitr.fFormsfll? RESlDENTIAl
Additional Fees